More than 2 million children and youth in the U.S. are homeless at some time each year. Once on the streets, homeless youth frequently rely on high-risk survival behaviors to meet their basic needs. Compounding these high-risk behaviors, these youth also have histories of depression, low self-esteem, trauma, substance abuse, and physical and sexual abuse. Despite the myriad mental health issues homeless youth confront, their rates of engagement in existing services are limited. To date, the field also lacks a recruitment protocol for engaging and retaining homeless, street youth in vocational and mental health services. The overall goal of this PAR-06-248 R34 proposal is to enhance the engagement and retention of homeless youth with mental illness in our previously piloted and refined Social Enterprise Intervention (SEI), a vocational intervention integrated with clinical services, specifically designed for homeless, street youth with mental illness, high-risk behaviors and limited service engagement. The SEI seeks to improve street youths'engagement and retention in vocational and mental health services, and to increase their social support, life satisfaction, service utilization, and mental health and functional status through peer mentoring, job training, clinical services and harm-reduction strategies. The specific aims of our study are to: 1) develop and implement a peer-based service engagement protocol with homeless youth;2) develop strategies for increasing their retention in vocational and clinical services;3) revise and finalize a manualized version of the SEI to include the engagement protocol, retention strategies, and fidelity and sustainability measures for future model replication;and 4) conduct a pilot study of the revised SEI manual and engagement protocol with 72 homeless youth (36 intervention and 36 control-group youth) to assess the intervention's impact on various treatment outcomes. We propose a randomized experimental design with repeated outcome measurements at baseline and at 8- and 14-month follow-ups. Building upon the 5-year partnership between the USC School of Social Work and the host agency, My Friend's Place, this study addresses the fundamental issue around identifying effective vocational programs for street youth within agency settings. Presently, there are limited examples of community-based participatory research endeavors that involve the practice community in the design, implementation and evaluation of interventions. As such, this study supports one of NIMH's key research priorities to expedite evidence-based practices into clinical settings. Several products will be available from this study: 1) a revised SEI treatment manual that will include engagement and retention protocols, fidelity measures and sustainability strategies;2) baseline information of sample characteristics and variable distributions to help plan our large-scale, randomized intervention trial;3) pilot data on subject recruitment, randomization, data collection and SEI implementation processes for our future randomized trial;and 4) an R01 application to test the effectiveness of the SEI in a subsequent randomized clinical trial. PUBLIC HEALTH RELEVANCE: More than 2 million children and youth in the U.S. are homeless at some time each year. Major depression, post-traumatic stress disorder, and conduct disorder are found to be three times higher in homeless youth than in youth who have not left home. Given their low service utilization, combined with high-risk street behaviors and mental health problems, these youth are at risk for developing new and exacerbating existing mental health illnesses as well as for chronic homelessness. The proposed study responds to this pressing public health need by developing strategies for engagement and retention of homeless youth with mental illness in a comprehensive vocational intervention integrated with clinical services (the Social Enterprise Intervention), designed to enhance the youths'mental health, behavioral, social and functional outcomes.